Why women are opting for C-sections

  • Rhythma Kaul &Riddhi Doshi, Hindustan Times
  • Updated: Jan 31, 2016 14:28 IST
The number of C-sections in private hospitals is rising, as women have babies later, tackle lifestyle diseases or opt to pick a date and avoid labour. (Shutterstock)

When Neha and Santosh Singh were told that she was likely to deliver their baby around February 5, they had a thought — why not time it to coincide with their wedding anniversary on January 27 instead?

“We hadn’t thought of it earlier,” says Santosh, 30. “But when we were told the date, we thought Jan 27 would be a better day.” Neha underwent a C-section, accordingly, on the date of their choice.

“Since it was a special day for her, she wanted her child to be born then,” says Dr Anuradha Kapur, Neha’s doctor and the head of obstetrics and gynaecology at south Delhi’s Max Hospital. “She also had other complications, because of which we had to operate her. It worked out well for her.”

Neha Singh with her newborn baby, Saanvi at Max Hospital Saket, in New Delhi on Friday, January 29. (Photo by Sanjeev Verma/Hindustan Times)

A request from the mother is now the fifth most common indication for Caesarean sections, after non-progressive labour, fetal distress, excessive bleeding and the baby having pooped inside, Dr Kapur adds.

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At private hospitals across the country, natural childbirth is being passed over by couples like the Singhs, in favour of C-sections. National Family Health Survey data released last week indicated that private hospitals had almost twice as many C-section deliveries as public or government-run ones.

According to the World Health Organisation, the rate of C-section deliveries should be not more than 15%. However, even globally, this percentage has gone up to as much as 40%, particularly in countries such as the US and UK. “I would say 20% of the pregnant women want a particular delivery date and time,” says Dr Kapur.

Obstetricians add that the number of women wanting an elective Caesarean has seen a jump over the past two or three years. “The main reason is that many only plan to have one child, and due to late marriages pregnancies are being meticulously planned,” says Dr Kapur.

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Opting for the knife
Some women choose to have a C-section because of an extreme fear of labour pain; others do not want to opt for a vaginal route as they find it ‘gross’, says gynaecologist Dr Jeroo Bhada, associated with Mumbai’s Parsee General hospital. “This is unfounded as there are several ways to ensure a pain-free normal delivery now. And of course there are mothers who see a natural delivery as risky and opt for the C-section as a safer bet,” she adds.

Doctors say they try and counsel couples, particularly the mothers, to go the natural way, underlining that a natural delivery is a healthier option for a fit mother and a fit baby.

“We also explain that the probability of delivering a second child normally drops by 50% if the first delivery is via C-section,” shares Dr Bandana Sodhi, a senior ob-gyn consultant at New Delhi’s Moolchand Hospital. “Some do see reason,” adds Dr Kapoor, “but many remain adamant.”

The flip side
There are lifestyle factors at play too. Lack of activity, late conception, babies conceived through assisted reproductive techniques resulting in twins or triplets are also contributing to the rise in the rate of Caesarean sections in the urban population, doctors add. “More affluent women are opting for the surgery because of late pregnancies and lifestyle conditions such as diabetes or high blood pressure,” says Dr Kiran Coelho of Lilavati hospital.

In some cases, families feel that it’s best to minimise the risk involved.

The Suranas, for instance, a restaurateur family from Mumbai, had waited six long years for a child.

Sheetal even began considering IVF or in-vitro fertilisation, but a month before they were scheduled to begin the treatment, she conceived naturally. “From then on, we didn’t want to take any chances whatsoever,” says the 29-year-old mother.

When it came time for the delivery, last July, the couple opted for a C-section at a high-end private hospital, to put their minds at ease. “During the crucial hours of childbirth, we didn’t want to take any risks,” Sheetal adds. “What if my blood pressure shot up during labour, for instance?”

Another advantage of the C-section, Sheetal adds, was that the couple could time the birth. “We were told that July 20, between 11am and noon, was an auspicious time for the baby to be born, so that’s when I asked my gynaec to operate upon me,” she says.

In Sheetal’s case, her doctor adds, there was also the possibility of complications.“Most expecting mothers in private hospitals are from the affluent classes and have healthier babies, often weighing above 5 lb,” says gynaecologist and obstetrician Dr Ranjana Dhanu of the Mumbai-based Hinduja Healthcare Hospital, Khar, who operated upon Sheetal.

“At the same time, squatting has become rare, particularly among this group of women, overall activity levels have fallen, and the women tend to be slight with narrow hips. Usually in such cases a C-section is suggested — to minimise risks. Sheetal’s was a precious pregnancy. Also, her reports showed a floating head held high in the pelvis, rather than dipping into it. This could have potentially been dangerous for the baby.”

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